Epidemiology of Urological Cancers in Brazil: Trends in Mortality Rates Over More Than Two Decades

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Abstract

Background

Considering the socioeconomic disparities and inequalities observed in the healthcare resources among the Brazilian regions, we aimed to analyze the mortality trends of urological cancers in Brazil to identify areas with differential risks.

Methods

Deaths related to prostate (PCa), bladder (BCa), kidney (KC), penile (PeC), and testis (TCa) cancers from 1996 to 2019 were retrieved from the Mortality Information System database (Brazil). Geographic and temporal patterns were analyzed using age-standardized mortality rates (ASMRs). A joinpoint regression model was used to identify changes in the trends and calculate the average annual percentage change (AAPC) for each region.

Results

In Brazil, the ASMRs (per 100,000 persons/year) were 11.76 for PCa; 1.37, BCa; 1.13, KC; 0.33, and PeC; 0.26, TCa over the period. Increasing mortality trends were registered for BCa (AAPC = 0.45 in men; 0.57 in women), KC (AAPC = 2.03 in men), PeC (AAPC = 1.01), and TCa (AAPC = 2.06). The PCa mortality presented a significant reduction after 2006. The Northeast and North regions showed the highest increases in the PCa mortality. The South registered the highest ASMRs for BCa and KC, but the highest increasing trends occurred in the men from the Northeast. The North presented the highest ASMR for PeC, while the South registered the highest ASMR for TCa.

Conclusion

Differences among regions may be partly explained by disparities in the healthcare systems. Over the study period, the North and Northeast regions presented more discrepant mortality rates. Efforts should be made to ensure access to the healthcare resources for people at risk, particularly in these regions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44197-022-00042-8.

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Most cited references 27

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Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

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Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

Christina Fitzmaurice, Christine Allen, Ryan M Barber … (2017)

IMPORTANCE Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.

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Permutation tests for joinpoint regression with applications to cancer rates

Hyune-Ju Kim, Michael P. Fay, Eric Feuer … (2000)

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Author and article information

Contributors

Thiago Camelo Mourão:

ORCID: http://orcid.org/0000-0003-4800-6009

thiago.mourao@accamargo.org.br

Journal

Journal ID (nlm-ta): J Epidemiol Glob Health

Journal ID (iso-abbrev): J Epidemiol Glob Health

Title: Journal of Epidemiology and Global Health

Publisher: Springer Netherlands (Dordrecht )

ISSN (Print): 2210-6006

ISSN (Electronic): 2210-6014

Publication date (Electronic): 31 May 2022

Publication date PMC-release: 31 May 2022

Publication date Collection: September 2022

Volume: 12

Issue: 3

Pages: 239-247

Affiliations

[1 ]GRID grid.414374.1, Department of Uro-Oncology, , BP-A Beneficência Portuguesa de São Paulo, ; São Paulo, Brazil

[2 ]GRID grid.413320.7, ISNI 0000 0004 0437 1183, Graduate School, , Fundação Antônio Prudente, ACCamargo Cancer Center, ; R. Prof. Antônio Prudente, 211, São Paulo, 01509-010 Brazil

[3 ]GRID grid.413320.7, ISNI 0000 0004 0437 1183, Department of Statistics and Epidemiology, International Research Center, , ACCamargo Cancer Center, ; São Paulo, Brazil

[4 ]GRID grid.413320.7, ISNI 0000 0004 0437 1183, Division of Urology, , ACCamargo Cancer Center, ; São Paulo, Brazil

[5 ]GRID grid.414374.1, Surgical Oncology Department, , BP-A Beneficência Portuguesa de São Paulo, ; São Paulo, Brazil

Author information

Thiago Camelo Mourão http://orcid.org/0000-0003-4800-6009

Maria Paula Curado http://orcid.org/0000-0001-8172-2483

Renato Almeida Rosa de Oliveira http://orcid.org/0000-0003-2872-5815

Thiago Borges Marques Santana http://orcid.org/0000-0002-3150-6595

Gustavo Cardoso Guimarães http://orcid.org/0000-0002-1317-2114

Article

Publisher ID: 42

DOI: 10.1007/s44197-022-00042-8

PMC ID: 9470798

PubMed ID: 35639266

SO-VID: ae05ae81-0919-4681-bcb9-847b62598a11

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 28 November 2021

Date accepted : 9 May 2022

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Keywords: urological cancers,epidemiology,mortality rates,average annual percentage change

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Keywords: urological cancers, epidemiology, mortality rates, average annual percentage change

Epidemiology of Urological Cancers in Brazil: Trends in Mortality Rates Over More Than Two Decades

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SciELO Brazil

Most cited references 27

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

Permutation tests for joinpoint regression with applications to cancer rates

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